Relationship between Age; Radiographic Normal Heart Size and Cardio-Thoracic Ratio in a Nigerian Population

Background: Cardio-vascular disease (CVD) is now on the increase. The precise diagnosis of CVD is of immense clinical importance to the cardiac surgeons; pathologist and also for cardiologists. However; information on normal values for various cardio-vascular structures in Nigeria; a country with the highest population of blacks in the world is sparse. In this regard the age-related radiographic sizes of a Nigerian cohort of patients with non-cardiogenic complaints or consultations were therefore assessed.Objectives: To evaluate the limits of normal cardiac size in our environment ; determine if there was a relationship between the age and size of the heart and to evaluate the relationship between sex and cardiac size and cardio-thoracic ratio.Design: A cross-sectional study.Setting: The Radiology department of University of Ilorin Teaching Hospital; Ilorin; North Central Nigeria between January to June 2012.Subjects: One Hundred patients were consecutively recruited and their chest radiographs examined after fulfilling the inclusion criteria.Results: Males accounted for 55% of the study population. The age range was 1 month to 73 years; (Mean = 29.3; SD =2.41668). The mean cardiac size was 11.7cm. The average cardiac size for adult males and females; were 11.6cm and 11.5cm respectively while that of thoracic size was 29.0cm and 26.8cm respectively. Correlation between age and cardiac size was 0.66; age and thoracic size was 0.64 and between cardiac size and thoracic size was 0.89. The paired sample t-test for age and cardiac size was less than 0.05 (p value 0.05).Conclusion: knowing the average values of cardiac size for adult males and females (11.6cm and 11.5cm) and thoracic size (29.0cm and 26.8cm) respectively from this study presents a base line for early detection of variation from normal cardiac measurements in this environment

Early experience with outpatient tube drainage for management of pleural collections

BACKGROUND: Increasing cases of pleural effusion leads to pressure on bed spaces and a stretch of the limited facilities available for intervention in our centre. This therefore prompted a search for acceptable alternative way of treatment. OBJECTIVE: To evaluate the use of ambulatory drainage system for chronic infectious and malignant pleural effusion on outpatient basis. METHODS: Eight of 113 routinely performed closed tube thoracostomies drainage were converted to ambulatory drainage system at the time of patients' discharge to follow-up clinic. This was after the catheter care had been thoroughly explained to the patients and their relatives. RESULTS: Eight patients (seven males and one female) had ambulatory outpatient tube management. Their mean age was 44.9 ± 18years with a range of 22­70 years. Histologically confirmed causes of the effusion were; metastatic adenocarcinoma in two(25%) of the cases; chronic non-specific inflammation in another two(25%) and tuberculous empyema thoracis in three(37.5%) one of whom had TB/HIV co-infection and one(12.5%) of chronic bacterial parapneumonic empyema. One case each of metastatic adenocarcinoma and chronic nonspecific suppuration had failed chemical pleurodesis before the outpatient drainage procedure. Half of the cases (including tuberculous and non-tuberculous) were successfully weaned off their catheters. Minor complications such as pain, discomfort, minimal stoma bleeding, and peri-catheter leak were recorded. Rapid fluid re-accumulation prevented weaning in two (25%) of the cases. CONCLUSION: Out-patient chest tube drainage is effective for the management of both malignant and suppurative pleural effusion. This approach would reduce the ever increasing cost of hospital care for this group of patients. WAJM 2009; 28(6): 364­367